Doctors' code of silence will hide under-age sex from parents

Doctors have been ordered to 'respect the rights' of children to make decisions for themselves

Parents will be denied the right to know if their child is having under-age sex under controversial guidelines for doctors unveiled yesterday.

Doctors were told they should not tell parents if children up to three years below the age of consent approach them for contraceptives or an abortion.

There will even be times when parents would not be informed if children under 13 are sexually active.

The General Medical Council said last night that this would apply where doctors believed an under-age patient might harm themselves or run away from home if the information were shared with their family.

The written guidance from the GMC is the first time that the medical establishment has given its blessing to the growing practice of GPs handing out condoms and authorising abortions for teenage girls, often without parents having any idea their child is sexually active.

The guidance also controversially advises that children should have the overriding decision on their own healthcare in general, meaning, for example, that a child with cancer would be able to turn down life-saving but painful treatment without their parents having a final say.

It says that in many cases doctors should tell concerned mothers and fathers to leave the room to ensure a child is as open as possible about health problems, including sexual activity.

The guidance was condemned yesterday as "wicked" by family groups, who said it effectively legitimised underage sex.

The medical establishment's formal recognition of children's rights to privacy and to make their own decisions further strips away the rights of parents, a trend which began in 1983 with the Victoria Gillick case, in which the courts told doctors not to tell parents if their daughters were on the Pill.

More recently the Children Act 2004 said that healthcare professionals, teachers and social workers should always put the well-being of children above the views of anyone else - even parents.

Nurses and sexual health charities insisted confidentiality was vital to bring down Britain's rates of teenage pregnancy, the highest in Europe.

Last year, Sue Axon from Manchester lost her fight for the law to be changed to stop under-16s seeking confidential advice on contraception and abortion.

The new GMC guidance says that if a child aged between 13 and 16 asks for advice on sexual health, for contraception or an abortion, the doctor should make an attempt to persuade them to tell their parents.

But if the child is determined not to do so, or will not give the doctor permission to tell them, the parents should not be informed.

Only under extreme circumstances should social services or the police be informed - such as if the child is having sex with a much older person.

The guidance states: "A confidential sexual health service is essential for the welfare of children and young people. Concern about confidentiality is the biggest deterrent to young people asking for sexual health advice.

"That in turn presents dangers to young people's own health and to that of the community, particularly other young people."

Under the Sexual Offences Act 2003, doctors are exempt from prosecution for "aiding and abetting" child sex through providing advice if their aim is to prevent sexual infections or pregnancy. It means they do not have to inform police.

Doctors must be able to justify why they have decided not to refer cases on, though, and could be struck off if the child comes to harm.

Stephen Green of Christian Voice described the guidance as "wicked".

He said: "The idea of using contraception to stop the spread of disease is a dead duck. It will lead to more abortions, more sexual diseases and more infertility."

Norman Wells, of Family and Youth Concern, said: "There is a very dangerous trend in supporting the so-called sexual rights of children. Health professionals are not doing young people any favours by helping them keep their parents in the dark.

"They are hardly encouraging them to value and respect their parents' role, and they are condoning underage sex with all its physical and emotional risks.

"We seem to be losing sight of the fact that the very reason we have an age of consent is to protect children.

"There is a very real danger that doctors may be placing children at risk of sexual abuse and exploitation by colluding with them to keep their sexual activity secret."

CONFIDENTIALITY

Doctors should respect the confidentiality of children just as they would do with adults, the guidance says.

It adds: "When treating children and young people, doctors must also consider parents and others close to them, but their patient must be the doctor's first concern."

Too often, children are afraid to go to their doctor with their parents, meaning their health needs are not met, the report adds.

"You should think carefully about the effect the presence of a chaperone can have. Their presence can deter young people from being frank and asking for help."

It means doctors could ask parents to leave the room if they are concerned a child is not being open enough.

TREATMENT

Some children may be mature enough to decide on which treatment they should have.

The guidance tells doctors that once a child has reached 16, it should be "presumed" they are mature enough to consent to treatment.

Many under-16s may have the capacity to consent, "depending on their maturity and ability to understand what is involved".

Parental opposition to the views of the child makes no odds.

The guidance states: "In England and Wales, treatment can be provided in the young person's best interests without parental consent.

"Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests."

SEXUAL ACTIVITY

In most cases, parents should not be told about their child's sexual activity if they are aged between 13 and 16, the GMC says.

Its guidance adds: "You can provide contraception, abortion and STI advice and treatment, without parental knowledge or consent, to young people under 16 provided that... you cannot persuade that person to tell their parents."

The doctor must also be confident that the child understands the advice, is likely to have unprotected sex, and their health is likely to suffer if they do not receive the treatment.

It adds that a doctor should "usually" tell social services and parents about sexual activity involving children under 13, because the law considers them too young to give their consent.